National Association Of Physicians


A remarkable opportunity now presents itself for the Association of Otolaryngology Administrators to take a major leadership role in helping to “green” — make more environmentally sound — the healthcare sector. That is joining with the National Association of Physicians for the Environment and the U.S. Environmental Protection Agency, as “partners” in improving energy efficiency in your offices, saving money and protecting the environment.

Otolaryngology Already Leads
After all, otolaryngology in the past several years has taken a leading role among medical societies in environmental matters. In 1992, the American Academy of Otolaryngology–Head and Neck Surgery, Inc., co-sponsored, with the National Institute on Deafness and Other Communication Disorders (NIDCD) of the National Institutes of Health (NIH), a conference on air pollution impacts on the upper aerodigestive tract; the scientific papers were later published in the Academy’s journal, Otolaryngology-Head and Neck Surgery. In early 1993 the Academy established a Committee on the Environment; also, in February of that year, the National Association of Physicians for the Environment (NAPE) and the Academy sponsored a national conference entitled “Physicians and the Environment” to help define areas of potential collaboration between physicians and the environmental community. Funded by the National Institute of Environmental Health Sciences of the NIH, this conference attracted more than 100 physicians and other health professionals, environmental leaders, and federal officials. Twenty out of the 25 medical specialties recognized by the American Board of Medical Specialties were represented. The featured papers discussed areas of mutual interest between the nation’s practicing physicians and environmentalists as well as the impacts of pollution on specific body organs and systems, an area in which the specialists presenting had extensive training and clinical experience.

In November 1994, NAPE hosted a second conference, co-sponsored by the Academy, entitled “Air Pollution Impacts on Body Organs and Systems.” This gathering produced the first comprehensive review of the effects of air pollution on each of the body’s major organs and systems. The peer-reviewed papers delivered at the conference were published in a special issue of the journal Otolaryngology-Head and Heck Surgery — (see volume 114, no. 2, 1996), and the National Library of Medicine abstracted them, making these papers part of the international medical literature obtainable via the Internet. NAPE also made available a comprehensive report about the conference, posting the document on the NAPEnet home page. NAPE is developing a slide kit for physicians and the general public about the health effects of air pollution. A version will soon be available via the Internet and on computer diskette.

The Academy also co-sponsored with NAPE, on May 22-23, 1997, an “International Conference on Water Pollution and Health,” which focused on water pollution and health. Attendees discussed the impacts of toxics and waterborne pathogens on drinking water systems and natural lake and river systems as well as the actions that need to be taken to protect our drinking water. NAPE hopes the meeting will lead to the establishment of a National Council on Water Pollution and Health dedicated to coordinating water protection and water pollution prevention activities among physicians and their healthcare colleagues, water treatment professionals, environmentalists, and consumers, especially during outbreaks of waterborne infectious disease.

On the international front, NAPE serves as the United States’ designated representative to the International Society of Doctors for the Environment (ISDE). Founded in Switzerland in 1990, ISDE currently has national organizations in more than 50 countries. A former president of the Academy, Byron J. Bailey, MD, is NAPE’s delegate to that body.

Also, the International Federation of Oto-Rhino-Laryngological Society is becoming more deeply involved in environmental issues.

New Opportunity

Now otolaryngology is taking the lead again, in energy efficiency.

Michael D. Maves, MD, MBA, Executive Vice President of the Academy, has agreed to serve as Chairman of the Council on Healthcare Energy Efficiency, working with NAPE and the U.S. Environmental Protection Agency (EPA). His experience in upgrading energy efficiency in the Academy’s headquarters at One Prince Street, Alexandria, Virginia, came to the attention of the EPA, which has done a case study on the project and plans to do a video segment for their video on energy efficiency opportunities in the healthcare sector.

Two years ago, Dr. Maves asked the Academy staff to analyze energy aspects of the Academy’s operations for cost savings. Recently he noted that, “All healthcare professionals know that cost-cutting in our offices and facilities is vital in this time of intense competition and managed care.
“One way to cut costs dramatically is to decrease energy use, in lighting, office equipment use, and heating and air conditioning in a facility. Many technological advances leading to increased energy efficiency have been made in the last several years.

“At the same time, improved energy efficiency will help keep the people we serve healthy, and protect the environment by preventing pollution.
“And while we are doing that, we can inform our patients and the community of the leadership role we are taking.”

He reports that, “Two years ago, we undertook a thorough review of cost-saving opportunities in our 25,000 square foot facility. One opportunity we immediately identified: energy costs. We found an energy efficiency contractor (companies doing this are present in almost every community) who gave us a free estimate of costs on energy efficiency upgrades, the payback period, and the projected annual future savings. One thing of most concern to me was that, on nights and weekends, lights and office machinery often were on, and heating and air conditioning were set at unnecessary levels for unoccupied space.

Lighting: We have replaced much older, less efficient lighting, and expect full payback within two years. Also, energy efficiency lighting produces less waste heat than non-efficient lighting, so we expect a lowering of air conditioning costs.

Office equipment: computers, copies, fax machines, and printers with EPA ENERGY STAR® labels have or will replace less energy efficient equipment.

HVAC equipment: No upgrades were necessary, but better preventative maintenance schedules have been put in place.

Computerization: All of the above are tied into a central computerized control system to maximize energy efficiency.

We expect complete payback in 2 to 3 years, and continuous savings, thereafter.”

But not only money has been saved. The Academy has, through these efforts, prevented considerable air pollution. The EPA sent a team to the Academy’s offices and with their software program determined the following pollution will be prevented yearly:

• 1,637 lbs. of sulfur dioxide — a respiratory irritant and component of acid rain;

• 705 lbs. of nitrogen oxide — a component of ground-level ozone (smog); and

• 192,000 lbs. of carbon dioxide — asserted to contribute to global climate change.

All this, while saving about $7,800 per year in energy costs.

Otolaryngologists’ Offices

The Academy is now a partner in EPA’s ENERGY STAR® Program — any physician’s office, facility, or hospital can become a partner and receive a free manual with complete “how-to” steps for any facility under 100,000 square feet, a draft press release to tell the community what is being done, and brochures to give to patients explaining what the office is trying to achieve through this “Pollution Prevention is Disease Prevention” initiative. You are invited to become a “partner” in this effort. (IMPORTANT NOTE: No project is suggested which does not have payback in two years or less and continuous savings thereafter.)

The above materials will be ready on September 1 of this year. Simply write on office letterhead to the following address and EPA will receive the request immediately. NAPE will provide a certificate of registration to your office. All materials will be sent after September 1, 1997.

National Association of Physicians for the Environment (NAPE)
6410 Rockledge Drive, Suite 412
Bethesda, MD 20817-1809

“Greening” of Otolaryngologists’ Offices

But more can be done. Ten of the leaders of your Association of Otolaryngology Administrators have recently received a draft of “A Physicians’ Green Office Guide,” completed by NAPE, the National Wildlife Federation, and the Environmental Alliance for Senior Involvement. All aspects of physicians’ offices are dealt with in regard to environment protection.

They are reviewing the 30-page draft for workability and ease of use. NAPE expects a report soon.
Your Association is invited to join the 33 medical organizations now members of NAPE, including the American Medical Association, the American Academy of Otolaryngology-Head and Neck Surgery, the Society for Head and Neck Surgery, and 30 others in this effort.

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